Is it possible to prevent an injury to my ACL when playing sports? Of course! Research suggests that when incorporating a proper ACL injury prevention program, we can possibly reduce the risk of ACL injury by 52% in female athletes and 85% in male athletes (Sadoghi et al., 2012).
What exactly is an ACL injury?
The Anterior Cruciate Ligament (ACL) helps stabilise our knee by connecting the femur (thighbone) to the tibia (shinbone). This restricts the ability of your shinbone to move to far forward from the thighbone when engaged in activity (Brukner and Kahn, 2012).
The ACL is most commonly injured in sports where participants land from a jump, suddenly stop, change directions or pivot in sports like football, basketball, soccer, or downhill skiing. There may be an audible crack or pop, painful sensation and/or fast swelling of the knee joint on injury (Brukner and Kahn, 2012).
What can I do to prevent an ACL injury?
Strength Training
It is important to strengthen the muscles surrounding the knee like the quadriceps, hamstrings, and gluteal muscles.
The quadriceps can be strengthened with exercises such as knee extensions, squats, lunges or leg presses.
The hamstrings can be strengthened with exercises like hamstring curls, lying stability ball hamstring curls, deadlifts/single leg deadlifts and the Nordic hamstring exercise.
The gluteal muscles can be strengthened with exercises like side-lying hip abduction, clam exercise and bridges.
Practicing Proper Jumping and Landing Technique
The program should involve the athlete practicing his or her jumping and landing techniques with the correct biomechanics. The athlete can bring a partner or a coach to provide feedback on the technique.
When landing, the knee should remain in a straight line above the middle toe or slightly pointed outwards away from each other. The knees should never travel inwards towards each other as this puts stress through the ACL (valgus stress). The athlete should have a slight bend in the knee’s and the hips when landing and try to land in a controlled manner with more weight placed through the forefoot rather than the heel (Voskanian, 2013).
Plyometric training
Plyometric training involves high intensity agility drills which work to improve footwork by developing power and speed. This can involve agility drills like quick sprints, stops and starts, cutting, lateral movements and jumping. These activities should mimic the quick motor responses that an athlete would perform in a game situation (Voskanian, 2013).
When should I start and how often do I need to perform the exercises?
The ACL prevention program would be most effective in preventing injury if it is initiated 6 weeks prior to engaging in high-intensity sporting activity. One training session should last approximately 15-30 minutes and should be completed at least 3 times weekly. The program should be completed through the competitive season and can be used as a warm up prior to engaging in sporting activity (Voskanian, 2013).
Where can I find ACL prevention programmes?
The FIFA 11+ injury prevention program is a great place to start, as research has shown that it can increase the incident of ACL injuries in male soccer players by 77%! (Silvers-Granelli et al., 2017). You can find the whole programme here.
In conclusion, strengthening the muscles in the legs, practicing your jumping and landing techniques and training your agility skills will help minimise the risk to your knees!
References:
Brukner, P. (2012). Brukner & Khan’s clinical sports medicine. North Ryde: McGraw-Hill.
Sadoghi, P., von Keudell, A., & Vavken, P. (2012). Effectiveness of anterior cruciate ligament injury prevention training programs. JBJS, 94(9), 769-776.
Silvers-Granelli, H. J., Bizzini, M., Arundale, A., Mandelbaum, B. R., & Snyder-Mackler, L. (2017). Does the FIFA 11+ injury prevention program reduce the incidence of ACL injury in male soccer players?. Clinical Orthopaedics and Related Research®, 475(10), 2447-2455.
Voskanian, N. (2013). ACL Injury prevention in female athletes: review of the literature and practical considerations in implementing an ACL prevention program. Current reviews in musculoskeletal medicine, 6(2), 158-163.
